Surgical instrument for implanting capillary seeds containing radium emanation



Jan. 20, 1931. J. Mum v SURGICAL INSTRUMENT FOR IMPLANTING CAPILLARY SEEDS CONTAINING RADIUM EMANATION Original Filed July 19, 1924 `seeds in accordance with the YPatented Jan. 20, 1931 UNITED :STATES PA'r`..1=..1,\1r ori-'ics i A.minimi Mum, or NEW YORK, `1v. AssIGNoR To THE RADIUM EMANATION oon-Pomfrion, AoonroRATIoN or :DELAWARE SURGICAL INSTRUMENT ,Fon IMPLANTING CAPILLARY snnns coNraI'NrNG Ranma:

Y EMANATION Continuation in part of application serial Nu. 727,094, filed Juiy 19,*1924. Thisappuca'tin inea :my

' 3o, 1925. seria; 119,117,101.

This invention relates to an linstrument for iin-planting radium ema-nation capillary tubes, technical-ly known-as l:bare tubes -or seeds, lin biological tissue. Y y

Radium emanation tubes contain radium emanation in `equilibrium with the products `ofdecom-position of radium emanation. The

tubes are made of glass and Aat each end have a glass ball formed in sealingfthe tube.' rlhe dimensions are usually 1/2 mun-in ldiameter and 3 mm. in length. The short length ofthe -tube rand its Ymethod yof manufacture confer .thereon great strength and resistance lto {prespressure 1s exerted frombothsure ,when this ends.

In using fthe-tube orseeds, vit is to 'be noted that they are limplanted in solid tissue, ina solid mass, not at random but in a predetermined position. llhesetubes or seeds areinot dropped into opencavities of biological `:tissue but are positioned in the solid tissue so that they will remain in situ. In positioningthe bareftubes or seeds they are implanted under pressure so as to .break the biological tissue while beinglguided by .a suitable seed guide.

Radium ema-nation capillary tubes Roannot be .handled with the bare hands; the employment of a forceps is absolutely necessary. In View of the above yit is obvious that any instrument in order Ato adequately vtake care of the requirements ofa radium emana- .tion .tube implanter, vmust be of such a nature that it can be used without the person handling it touching Ithe emanation tube. Further, the time element `1n handling is of great importance. Therefore, the implantation instrument or needle used must be vcapable Vof allowing the entire process of loading the emanation tubes or seeds into the instrument and implanting the seeds inthe biological tissue to be carried out quickly so as :to allow the implantation operator to zibe eX- posed to a minimum of radiation.

It is the primary object of this invention `to .provide an instrument -for implanting above stated requirements. Specifically, the invention has tor-its objects the implant-ation of the seeds,

under pressure soas to break fthe solid biologi- `ly `.inserted in its `tubular encasing fbody p0r- Vtion; f-

:the

:tion :tube vin "final cal tissue under pressure while said lseeds are being guided; the provision of a needlehav- Ving a plunger Shaving portions `of diiferent -ieXibifl-ity so as to give a certain amount of elasticity while the seeds are being implanted 4under pressure; the' provision `of a needle which will l'make fits own portalof rentrance :in solid tissue, and successfully force a` seed `througgg-h the needle and'into the .tissue at .the place `where' the point of the needle is :situated ina minimum of time so as :to reduce .the radiation :influence ito which the :operator gis tsubjectedi; and .the provision ofia' needle having a :loading slot, particularly .adapted to receive a single seed and allow it tofibeV implanted before 4the needle is charged with .another seed.

Inthe :accompanying drawing,

,Figi lis Va llongitudinal section partly in elevation, the Vplunger feeding element .being shown in .an Yextracted position; Y .F 1g. 2 is asimilar view to Fig. 1y butthe `plunger feeding element visshown complete- Fig. Bisanelevation ofthe plunger; F ig. 4 is an enlargedelevation .of vthe complete instrument;

Fig. 5 ,isza cross section Fig. 1;; i

Fig. f6 is a diagrammatic lview showing needle vproper and a :tube ,before the llat- ;ter has begun to .break the solid tissue;

. Fig. v7 isa similar `viewshlowing the tube' after itfhas .made its `own portal of entrance into fthe solid tissue, and i -8 is a similar View showingthe emanaposition allowing lthe removal of lthe instrument.

inthe drawing, wherein V.for the purpose of illustration .there fisshown a preferred embodiment of this invention, the nurneral l on line r5 5 of- .fdesig-nates as an entirety 4the body `zportion of the 4instrument and the numeral Zas `an -tion comprises an upper tubular body portion 3 and a lower tubular :body portion 4,

:the outside diameter .of 'the latter being greater :and inside diameter less than that ot the lformer thereby providing bores -5 and 16 which joins the elongated needle terminal 15 to theA said lower body portion. The

n elongated needle terminal 15 terminates in lower plunger portion 8 an inverted rustum of a cone 14 which receives the needle 12. The plunger 2 is composed of an upper plunger portion 7 having a diameter slightly less than the inside diameter of the. tubular upper body portion 3, and a lower plunger portion 8 of slightly less diameter than the inside diameter of the tubular lower plunger portion 4. The which is joined to the upper plunger portion 7 at 9 is of notably greater flexibility than the upper plunger portion 7 so as to provide for a certain amount of flexibility and elasticity while the emanation seeds are being implanted under pressure. The lower plunger portion 8 is about one and three quarters times as long as the upper plunger portion 7, the relationship being desirable so as to insure the proper degree of elasticity. It will be seen that this construction of the plunger is important when it is considered that the seeds or tubes.

are implanted under pressure and make their own portal` of entrance into the solid tissue. It the seeds were to be inserted into a biological cavity, this construction would not be necessary. The joint 9 may be a solder joint. At the outer end of the body portion 1 and the plunger 2 there are viiared ends or heads 10 and 11. The head 11 of the plunger is of slightly larger diameterthan that of head 10 of the body portion 1. This insures rapid withdrawal of the plunger and this is absolutely necessary in order to carry out the process of implantation in the minimum time.

The needle 12 is joined to the lower body portion 4 by means of needle terminal 15 and theinverted cone lrustum 14 which acts as a rest when the needle is inserted into the tissue. The needle is provided with a point 13 formed by beveling off the needle proper at an acute angle. The walls of the lower portion of the needle act as a guide and prevent transverse displacement of a seed as it passes through the needle and into the solid tissue. It is to be noted that the needle does not makea cavity which iinally receives the seed or tube. @n the contrary, the emanation tube, due to the pressure exerted thereon Jrorms its own portal of entrance in the solid tissue as illustrated in Figs. 6, 7 and 8.

In the lower tubular body portion 4, there is formed a countersunlr groove 18 communieating with bore 5 in the body portion 4 said eountersunk groove permitting the insertion ot emanation tubes within the bore 5. The more 19 which is positioned slightly below the needle is reached.

the shoulder 17 has side walls 19 and 2O and end walls 21 and 22 all extending at an acute angle to the axis o't the bore 5. The uppermost portions of thewalls 19 and 20 are in a plane slightly below the level of the plane Vdelined by the uppermost portion of the walls 21 and 22, said uppermost portion of the walls 21 and 22 being inthe circular plane of the lower body portion 4.

A countersunk groove of the construction specilied is advantageous in that it allows the insertion of but one emanation tube at a time and this is `quite necessary since the emanation capillary tubes can not, due to their shape, be bunched in a loading maga- Zine. For many years, instruments having loading magazines have been used to inject medicinal substances in open cavities but not in solid tissue. Vhen injecting the emanation tubes in solid tissue, each tube is usually positioned dierently. rTherefore, a loading magazine is not desirable and further, as stated it cant be used when injecting radium emanation tubes due to their shape.

The operation of the instrument is as follows:

Upon the withdrawal of the plunger 2 from'the lower body portion 4 and bore 5, the entrance 23 to the bore 5 is uncovered and an emanation tube 24 is placed in countersunlr groove 18. 'When the tube 24 is positioned within the bore 5, the plunger 2 is moved downwardly thereby forcing the tube 24 into the guiding needle 12 and then out of the same into solid tissue.

Upon inspection of Figs. 6, 7 and 8 it will be clear how the emanation tubes are placed in the solid tissue. The capillary tube after being placed in the countersunk groove 18 travels easily through the bore 5 or the body portion and through the needle 12 when pushed. by the plunger 2 until the point of In this position, the further end 28 of the emanation tube is in direct contact with the tissue 27 while the other end 26 of the tube is in contact with the lower body portion 8 of the plunger'2, the plunger, ot' course, exerting pressure as it is vmoved dowinvar'dly. Fig. 6 shows the position of the tube just before the tissue is broken. Further pressure upon the plunger portion 8 causes the capillary tube 24 to ad- Vance to a position illustrated in Fig. 7. As the tube 24 advances it is guided by the walls of the lower portion of the needle end and is thereby held against transverse displacement partially by said guiding walls and partially by the walls formed by the broken tissue. The portion A indicated in Fig. 7 of the needle acts as the guide. lVhen breaking the tissue the capillary tube makes its own portal of entrance and on continued pressure the tube is substantially completely inserted into the solid tissue as shown in 8. Thereafter the instrument may be removed. The

to-be placed further from the surface of the tissue is implanted first, ollowing'the procedure outlined above. To implant'tlieV next radium emanation tube, vthe plunger-and needle are drawn back so `that the point of the needle will beat the place where the new emanation tube is to be implanted. The instrument is charged again with the radium emanation tube and the plunger pushed all the way in so as to place the radium emanation tube in the required position. v

It is Adesired to point outI that the radium emanation tubes are very small and made oi glass. Since the material of .the tube of this character, it is quite necessary to Afeed the instrument .but vone tube at a ti ne. It several tubes were inserted at once there would be the possibility oi the production ot glass chips which is fatal. Before the introduction of applicants instrument and the process ot' applying the emanation tubes to the instrument, it was -usual to inse-rt the emanaton tube in the point 13 of the needle and then, in order to avoid loss of the tube,

to apply a little paraiin to theneedle and tube whereby the latter was temporarily held in place until the plunger ot' the needle was moved downwardly and contacted with the tube. Continued movement `of the plunger forced the tube into the tissue. his method of procedure has -Yseveral disadvantages. First, the possibility ot losing the tube in applying theparatin is very great; second, each time a tube had to be inserted, the instrument had to be removed from the tissue. According to applicants process of vinserting the vemanation tube, the use otparalin Vis avoided and when successive tubes are to be inserted into the tissue, the instrument need not be withdrawn from the tissue. All thatV is necessary is that the plunger be raised so as to uncover the loading slot 18, insert the tube and advance the plunger downwardly.'

Of course, usually, when several tubes are to be -inserted, they are placed in diierent positions. In this case the ,instrument needle is not completely withdrawn from the tissue but the needle is simply advanced or partially withdrawn to effect a change oi` iositio-n. In the old method of feeding the tubes, it was necessary to completely withdraw'the ins-trument from the tissue.

It to be noted that the countersunk groove 18 communieating` with the bore 5 in the body portion 4t is of such a size to hold a Asingle emanationseed and that this Agroove formsan :opening in the wall fof .the lbody portionV i orpermitting the insertion of; :an elongated emanation tube and positioning the seed so that its single longitudinal substanti ally coincides with the axis of the lower tubular body portion 4. v

The present 'application is ,a continuation in part ot U. tiled July 19, 1924 by Joseph Muir andJulius EfUnderwood. f

l. Inaninstrument `for implanting `radi-um en ianation tubes of capillaryy dimensions throughthe slrin and into solid tissue, such implantation requiring extreme care. in

manipulating the instrument in order to accuratelyra'diate the diseased ltissue ,avoid loss of the emanation tube, and subject the emanation'operator to a minimum exposure oi' radium emanation, the-combin ation of `a tubular upper vbody portion, a lower tubular body portion having an opening in its wall of such a size as to only permit the feeding of a single elongated emanation tube, vsaid opening being so constructed as toposition the tube with its single longitudinal aXis substantially coinciding with the longitudinal airis of the tubular body portion, a. needle terminal Y at the lower extremity of the .lower body portion, a guiding needle carried by said needle terminal and a plunger working in said ybody portions and needle and adaptedto foro-e the emanation tube under pressure through fthe needle, skin, and into or adjacentthe diseased tissue. Y

2. In `an instrument Yfor implanting radium emanation tubes of capillary dimensions through the skin and into solidtissue, such. implantation requiring extreme care in Inanipulating the instrument in order to accurately radiate the diseased tissue,.avoid loss of theemanation tube, and subject the emanation 'operator to a minimum exposure ot' radium emanation, the combination cia tubular upper body portion, a lower tubular 'body portion, means therein ior permitting the insertion of an elongated emanation tube, and positioning the tub-eso that its single longitudinal axis substantially coincideswith the axis of the lower tubular body portion, a needle terminal at the lower extremity of the lower body portion, a guiding needle in said needle terminal, and a plunger working in said body portions and needle and adapted to force Vthe emanation tube under ,pressure through the needle, skin, and into or adiacent the diseased tissue. y

3. `In an instrument for implanting radium emanation tubes of capillar f dimensions through the shin and into solid tissue, such implantation requiring estreme care in `ma.- nipulatingA the instrument in order to accurately radiate the diseased tissue, avoid loss ot the emanation tube, and subj ect the emanation operator to a minimum.exposure off maito S. application Ser. No. 727 ,1094,

so l

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um emanation, the combination of a tubular upper body portion, a lower tubular body portion of greater outside diameter and less inside diameter than the upper body portion, means in said lower tubular body portion for permitting the insertion of an elongated emanation tube and positioning the tube so that its single longitudinal axis substantially coincides with the axis of the lower tubular body portion, a needle terminal at the lower extremity of the lower body portion, a guiding needle carried by said needle terminal, and a plunger working in said body portions and needle adapted to :torce the emanation tube under pressure through the needle, skin, and into or adjacent the diseased tissue.

4. In an instrument for implanting radium emanation tubes oi' capillary dimensions through the skin and into solid tissue, such v implantation requiring extreme care in manipulating the instrument in order to accurately radiatethe diseased tissue, avoid loss of the emanation tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion of greater outside diameter and less inside diameter than the upper body portion, means in said lower tubular body portion for permitting the insertion of an elongated emanation tube and positioning the tube so that its single longitudinal axis substantially coincides with the axis of the lower tubular body portion, a needle terminal at the lower extremity of the lower body portion, a guiding needle carried by said needle terminal, the juncture of the needle and needle terminal forming a shoulder acting as a rest when the needle is inserted into the tissue, and plunger working in said body portions and needle and adapted to torce the emanation tube under pressure through the needle, skin, and into or adjacent the diseased tissue.

5. ln an instrument for implanting radium emanation tubes of capillary dimensions through the skin and into solid tissue, such implantation requiring extreme care in manipulating the instrument in order to ac` curately radiate the diseased tissue, avoid loss of the emanation tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of 'a tubular upper body portion, a lower tubular body portion, means therein for permitting the insertion of an emanation tube, a needle terminal at the lower extremity oic the lower body portion., a guiding needle carried by said needle terminal, and a plunger working in said body portions and needle and having an upper plunger` portion of a diameter slightly less than the upper tubular body portion, and a lower plunger portion of slightly less diameter than that of the tubular lower body portion and needle, the lower plunger portion having a notably greater flexibility than the upper plunger portion.

6. In an instrument orimplanting radium emanation tubes of capillary dimensions through the skin and into solid tissue, such implantation requiring Yextreme care in manipulating the instrument in order to accurately radiate the diseased tissue, avoid loss of the emanationv tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion of greater outside diameter and less inside diameter than the upper body portion, means therein for permitting the insertion of an emanation tube, a needle terminal at the lower extremity of the lower body portion, a guiding needle carried by said needle terminal, and a plunger working in said body portions and needle having an upper plunger portion of a diameter slightly less than the tubular upper body portion, and a lower plunger portion of slightly less diameter than that of the tubular lower body portion and needle, the lower plunger portion having a notably greater flexibility than the upper plunger portion.

7. In an instrument for implanting radium emanation tubes of capillary dimensions through the skin and into solid tissue, such implantation requiring extreme care in manipulating the instrument in order to accurately radiate the diseased tissue, avoid loss of' the emanation tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion 01": greater outside diameter and less inside diameter than the upper body portion, means in said' lower body portion for permitting the insertion of an emanation tube, a needle terminal at the lower extremity of the lower body portion, a guiding needle carried by said needle terminal, and al plunger working in said body portions and needle, having an upper body portion of a diameter slightly less than the tubular body portion and a lower plunger body portionV of slightly less diameter than that of the tubular body portion and needle, the lower plunger portion having a notably greater flexibility than the upper plunger portieri, the juncture of the needle terminal and needle forming a shoulder acting as a rest when the needle is inserted into the tissue.

8. In an instrument for implanting radium emanation tubes of capillary dimensions through the skin and into solid tissue, such implantation requiring extreme care in manipulating the instrument in order to accurately radiate the diseased tissue, avoid loss of the emanation tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion,

i and adapted to force the emanation tube under pressure through the needle, skin and into or adjacent the diseased tissue.

9. In an instrument for implanting radium emanation tubes of capillary dimensions through the skin and into solid tissue, such implantation requiring extreme care in manipulating the instrument in order to accurately radiate the diseased tissue. avoid loss of the emanation'tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion, a countersunk groove therein, the walls of which are at an acute angle for permitting the insertion of an emanation. tube, a needle terminal at the lower extremity of the lower body portion, a guiding needle carried by said needle terminal, and a plunger working in said body portions and needle and adapted to force the emanation tube under pressure through the needle, skin, and into or adjacent Vthe diseased tissue.

10. In an instrument for implanting radium emanation tubes of capillary dimensions through the skin and into solid tis-sue, such implantation requiring 'extreme care in manipulating the instrument in order tov accurately radiate the diseased tissue, avoid loss of the emanation tube, and subject the emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion, a countersunk groove in the upper portion of the lower body member for permitting the insertion of an emanation tube, a needle terminal at the klower .extremity of the lower body portion, a guiding needle carried by said needle terminal, and a plunger working in said body portions and needle and adapted to force the emanation tube under pressure through the needle, skin, and into or adjacent the'diseased tissue.

11. In an instrument for implanting radium emanation tubes of capillary dimensions through the skin and into solid tissue, such implantation requiring extreme care in manipulating the instrument in order to accuratel'y radiate the diseased tissue, avoid loss of the emanation tube, and subject the emanation operator to a minimum exposure of radium emanation, the Combination or a tubular upper body portion, a lower tubular body portion, a countersunk groove in the lower tubular body port-ion for permitting the insertion of an emanation tube, a needle terminal at the lower extremity of the lower body portion, a guilding needle carried by said needle terminal, and a plunger working in suchv implantation said bodyr portions and` needle, having an upperplunger portion of a'diameter slightly less; than thetubulary upperl body portion and a lower plunger body portion of slightly less diameter than that of the tubulary lower body portion and:needle,thelower,plunger portion having a notably greater flexibility than that of the upper plunger portion.l

.12. .In an` instrument for radium*- emanation tubesl of capillary dimen-y sions throughV the skin and into solid tissue, requiring extreme care-in manipulatingjthe instrument in order -toac-` curately radiate the diseased tissue,avoid loss of the emanation tube,y and` subject the emana-H "tionh operator to laminimum .exposureoffradium emanation, the combination of a tubular upper bodyV portion, a lower tubular body portion, a countersunk groove in the upper portion of the lowerbody member for permitting,v the .insertion of an emanation tube, said. groove having walls `extending at an acute angle tothe axis of said lower body member, the tops of the side walls being in a' different plane from the tops oi the end walls,I a needle terminal at thelowervextremity of the lower lbody portion, va guiding needle carried by said needle terminal, and -a plunger working: in said body portions andv needle and adapted to `force, the emanation tube/underv pressure through the needle, skin, and intoor adjacent the .diseased tissue. A 13. In: an.4 instrument for implanting radium emanation tubes of capillary dimen1 sionsthrough theiskin and into solid tissue, such implantation requiring extreme care ink manipulating thefinstrument in order to aecuratelfy radiate the diseased tissue, avoid loss of the. emanation tube, and subject thev emanation operator to a minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion ot greater outside diameter and less inside diameter than the upper body portion, means in said lower tubular body portion for permitting` the insertion of an elon gated emanation tube, a needle terminal at the lower extremity of the lower body portion, said needle terminal forming at its needle end an inverted frustum of a cone, a guiding needle carried by said needle terminal, the juncture of the needle and needle terminal forming a shoulder acting as a rest when the needle is inserted into the tissue, and a plunger working in said body portions and adapted to force the emanation tube under pressure through the needle, skin and into or adjacent the diseased tissue.

14. In an instrument for implanting ra-` emanation operator to al minimum exposure of radium emanation, the combination of a tubular upper body portion, a lower tubular body portion, means therein for permitting the insertion of an emanation tube, a needle terminal at the lower extremity of the lower body portion, a guiding needle carried by said needle extremity, and a plunger work*k ing in said body portions and needle and having an upper plunger portion of adiameter slightly less than the upper tubular body portion and lower plunger portion of slightly less diameter than that of the tubular lower body portion and needle, the lower plunger portion having a notably greater' flexibility than the upper plunger portion and being approximatelyv one and three quarters times as long. 15. An implanting instrument, as characterized, for implanting radium emanation capsules of capillary dimensions through the skin and into solid tissue, such implantation requiring extreme care in manipulating the instrument in order to accurately radiate the diseased tissue, avoid loss of the radium emanation capsule, and subject the emanation operator to a minimum exposure of radium emanation, comprising a tubular receiving chamber having intermediate its ends a `subV stantially cup-shaped recess with an elon gated opening in its bottom leading into the passage of the chamber for admitting a radium emanation capsule, said chamber having a tubular needle member extending from one end of its passage, vand a. rod movable throughout the passage of the chamber and needle member for discharging the capsule under pressure from the needle member through the skin and into or adjacent the diseased tissue.

' In testimony whereof I have subscribed my name hereto. t

JOSEPH MUIR. 

